Fifteen years follow-up of photorefractive keratectomy up to 10 D of myopia: outcomes and analysis of the refractive regression

PURPOSE: To evaluate outcomes of photorefractive keratectomy up to -10.00 D of myopia and -4.50 of astigmatism and to develop a predictive model for the refractive changes in the long term. SETTING: Vissum Corporation and Miguel Hernandez University (Alicante, Spain). DESIGN: Retrospective-prospective observational series of cases. METHODS: This study included 33 eyes of 33 patients aged 46.79±7.04 years (range 40-57) operated with the VISX 20/20 excimer laser with optical zones of 6 mm. No mitomycin C was used in any of these cases. The minimum follow-up was 15 years. The main outcome measures were: uncorrected and corrected distance visual acuity, manifest refraction and corneal topography. Linear regression models were developed from the observed refractive changes over time. RESULTS: Safety and efficacy indexes at 15 years were 1.18 and 0.83, respectively. No statistically significant differences were detected for any keratometric variable during the follow-up (p≥0.103). 15 years after the surgery 54.55% of the eyes were within ±1.00 D of spherical equivalent and 84.85% within ±2.00 D. The uncorrected distance visual acuity at 15 years was 20/25 or better in 60.6% of the eyes and 20/40 or better in 72.73% of the eyes. The correlation between the attempted and the achieved refractions was r=0.948 (p<0.001) at 1 year, and r=0.821 (p<0.001) at 15 years. No corneal ectasia was detected in any case during the follow-up. CONCLUSIONS: Photorefractive keratectomy is a safe refractive procedure in the long term within the range of myopia currently considered suitable for its use, although its efficacy decreases with time, especially, in high myopia. The model developed predicts a myopic regression of 2.00 D at 15 years for an ablation depth of 130 µm

Preparation for implementing the proposed EC Water Framework Directive in Finland

Finland reorganised its environmental administration in 1995 when thirteen Regional Environmental Centres (RECs) and one national agency called the Finnish Environment Institute (FEI) were created. The REC's and the FEI have been entrusted with functions related to water resources management. RECs and FEI together with the Ministry of Agriculture and Foresty have appointed a steering group which will supervise the implementation of the EC Water Framework Directive in Finlan

Fetishism and the social value of objects.

The idea of the fetish has a particular presence in the writings of both Marx and Freud. It implies for these two theorists of the social, a particular form of relation between human beings and objects. In the work of both the idea of the fetish involves attributing properties to objects that they do not 'really' have and that should correctly be recognised as human. While Marx's account of fetishism addresses the exchange-value of commodities at the level of the economic relations of production, it fails to deal in any detail with the use-value or consumption of commodities. In contrast Freud's concept of the fetish as a desired substitute for a suitable sex object explores how objects are desired and consumed. Drawing on both Marx and Freud, Baudrillard breaks with their analyses of fetishism as demonstrating a human relation with unreal objects. He explores the creation of value in objects through the social exchange of sign values, showing how objects are fetishised in ostentation. This paper argues that while Baudrillard breaks with the realism characteristic of Marx's and Freud's analyses of fetishism, he does not go far enough in describing the social and discursive practices in which objects are used and sometimes transformed into fetishes. It is proposed that the fetishisation of objects involves an overdetermination of their social value through a discursive negotiation of the capacities of objects that stimulates fantasy and desire for them

A Dynamic Enquiry into the Causes of Hyperinflation in Zimbabwe

The purpose of this study is to determine the causes of hyperinflation in Zimbabwe for the period February 1999 to December 2006 using appropriate econometric techniques. Results from long run and shot run econometric models shows money supply, black market for foreign exchange (US$) and lagged values of hyperinflation to be positively correlated with the country’s hyperinflation trend. This result accords well with the various theories of hyperinflation. Surprisingly, political rights index as a determinant is negatively associated with hyperinflation, suggesting that an increase in this variable reduces hyperinflation. This is against economic theory, which expects a positive sign for this, variable. Granger causality test is also conducted between money supply and hyperinflation to empirically test the direction of causality, while sensitivity tests are done to infer the effect of money supply shock on hyperinflation trend.

VEC MODEL OF DEVELOPING COUNTRY INFLATIONARY DYNAMICS a€“ AN EMPIRICAL STUDY a€“ THE CASE OF ROMANIA

One of the most difficult issues confronting that monetary authorities in many developing economies have to deal with is the management of a stable price environment. Inflation can create uncertainty, a low level of investment, and raise costs in generalinflation forecasting, monetary policy, developing countries, Romania, VAR model

The competing claims of crime versus heritage in A Memento for Istanbul, Ahmed Umit

This article notes the competing narrative drives, in A Memento for Istanbul byAhmed Ümit, of a crime police procedural and of a celebration of the history of Istanbul. It examines the tensions in play with these competing trajectories and questions whether they compete for attention in an expansive layering of the readerly experience, or pull in opposite and damaging directions? Noting that readers are always plural, and some will look for the whodunit while others will enjoy the historical information, the paper traces the different ways in which history is used in the novel, beginning with the obvious placing of the murder victims at the various cultural sites which trace the emerging history of the city, starting with Byzantium and ending in the present. This mix of taut crime narrative and travel guide, the article concludes, could perhaps be most usefully considered as a hybrid text, a ‘cross-over’ novel incorporating two separate generic expectations where neither is secondary to the other

The relationship between money and prices: some historical evidence reconsidered

This article describes a debate about the validity of the quantity theory of money and offers further evidence against it. The evidence is primarily from the North American colonies of Virginia, New York, and Pennsylvania and regards the issue of measuring the money supply. Studies have shown that changes in colonial money and inflation are inconsistent with the quantity theory. Some have argued that those studies measure money wrong: specie belongs in the measure because the colonies were on a fixed exchange rate system with Britain; changes in colonial paper money were offset by specie flows. When specie is counted, the quantity theory stands. This study responds with evidence that the critics are wrong: the colonies had no such fixed exchange rate regime, and movements in the stock of colonial paper currency cannot have been offset by specie flows. ; Reprinted in Quarterly Review, Fall 2002 (v. 26, no. 4)Money theory ; Economic history

Process Consistency and Monetary Reform: Further Evidence and Implications

In this paper we provide additional evidence that process consistency may have materialized as a restrictive constraint on the money generation process. In addition to recomputing the time series of process consistency probabilities using new data from the German case, we also supply our empirical technique to the data from the other hyperinflations studied by Cagan. We interpret our results as evidence hearing on the type of transversality condition studied by Brock or by Brock and Scheinkman as a sufficient condition to insure a unique equilibrium in optimizing models with perfect foresight and money.

Equity of Inpatient Health Care in Rural Tanzania:\ud A Population- and Facility-Based Survey

To explore the equity of utilization of inpatient health care at rural Tanzanian health centers through the use of a short wealth questionnaire.Methods: Patients admitted to four rural health centers in the Kigoma Region of Tanzania from May 2008 to May 2009 were surveyed about their illness, asset ownership and demographics. Principal component analysis was used to compare the wealth of the inpatients to the wealth of the region’s general population, using data from a previous population-based survey. Among inpatients, 15.3% were characterized as the most poor, 19.6% were characterized as very poor, 16.5% were characterized as poor, 18.9% were characterized as less poor, and 29.7% were characterized as the least poor. The wealth distribution of all inpatients (p < 0.0001), obstetric inpatients (p < 0.0001), other inpatients (p < 0.0001), and fee-exempt inpatients (p < 0.001) were significantly different than the wealth distribution in the community population, with poorer patients underrepresented among inpatients. The wealth distribution of pediatric inpatients (p = 0.2242) did not significantly differ from the population at large. The findings indicated that while current Tanzanian health financing policies may have improved access to health care for children under five, additional policies are needed to further close the equity gap, especially for obstetric inpatients.\u

Jeanette Winterson: interrogating masculinity with violence

Jeanette Winterson is known for the way she questions gender categories and confounds expectations of the feminine, from Villanelle’s active swashbuckling to the Dog Woman’s casual violence, from the unknown narrator of Written on the Body who rejects gendered identity to the fluid interplay of the narrator of The PowerBook shuffling between masculine and feminine via the engorged tulip, Winterson is someone we look to for texts that can unpack gender stereotypes. Her self-reflexive post modern texts deconstruct the divisions between masculinity and femininity